During our summer break, we're revisiting a compilation of previously released episodes about a healthcare system that is at once the most advanced in the world and one of the most broken. Hear Halle Tecco on why healthcare can't absorb its own innovation, Dr. Thomas Fisher on a system that's working exactly as designed, Lynn Jurich on the research gap that overlooked women's bodies, Kevin Caldwell of Ossium Health on prevention at the cellular level, and Andy Dunn on why mental health is health.  Together, these stories trace why the system stays broken and introduce the people working to change it. 

• Broken System: Halle Tecco on What it Takes to Build Massively Better Healthcare Listen here: Apple | Spotify
• Emergency Break: A Doctor's Case for Rebuilding the System, Not Just Treating the Symptoms Listen here: Apple | Spotify
• Shattering the Grid: Lynn Jurich on Electrifying Homes and Extending Women's Lives Listen here: Apple | Spotify
• Breaking Bad: Kevin Caldwell and Ossium Health is Banking on Bone Marrow for Curing Cancers and Transforming Longevity Listen here: Apple | Spotify
• The Breakdown: Andy Dunn on Building Bonobos, Battling Bipolar, and Baking Pie Listen here: Apple | Spotify

Halle Tecco Halle Tecco is a healthcare investor, operator, and educator who founded Rock Health, the first venture fund dedicated to digital health. An angel investor and longtime voice in health innovation, she frames healthcare around the "iron triangle," now four aims of better outcomes, greater access, lower cost, and a better experience, and argues the industry has "an implementation problem, not an innovation problem." In this episode she draws on case studies from her work, including PillPack and the cautionary tale of uBiome, to explain why the system so often rewards incumbents over better ideas. Connect with Halle Tecco on LinkedIn and at halletecco.com

Dr. Thomas Fisher Dr. Thomas Fisher is an emergency physician and the author of The Emergency: A Year of Healing and Heartbreak in a Chicago ER. Writing and practicing from inside an overwhelmed emergency department, he makes the case that the system is "working as designed," built to step in when things go wrong rather than to keep people well, and that its true moral purpose is to protect us when we are most vulnerable. In this episode he shares the story of a COVID-era patient he couldn't save, and how the same metrics that hide problems can be used to close equity gaps. Dr. Fisher is now a candidate for U.S. Congress in Illinois, carrying his case for rebuilding the system into public office. Connect with Dr. Thomas Fisher on LinkedIn and learn about his campaign at Thomas Fisher for Congress

Lynn Jurich Lynn Jurich is a serial entrepreneur best known as the co-founder and former CEO of Sunrun, which she led for 16 years and took public as the largest residential solar company in the U.S. After a health scare in her early forties, she turned her attention to female longevity, building a new standard of precision, prevention-first care for women. In this episode she confronts how little research exists on women's bodies, noting that before 2016, 80% of NIH studies were conducted only on men, and what it would take to change that. Connect with Lynn Jurich on LinkedIn

Kevin Caldwell Kevin Caldwell is the co-founder of Ossium Health, which is building the first large-scale bank of bone-marrow stem cells for cell therapies, and a Bridgewater Associates alum. Convinced that rising healthcare costs are better solved through biotechnology than through politics, he champions proactive, preventative medicine: banking your own stem cells while you're young and healthy, the way you might fund a 401(k). His guiding line, borrowed from Virgil's Aeneid: "the greatest wealth is health." Learn more about Ossium Health and connect with Kevin Caldwell on LinkedIn

Andy Dunn Andy Dunn is the co-founder and former CEO of Bonobos, the menswear brand acquired by Walmart, and the author of Burn Rate: Launching a Startup and Losing My Mind, a memoir about building a company while living with bipolar disorder. A leading voice on founder mental health, he speaks candidly about diagnosis, a second manic episode at the height of his success, recovery, and the conviction that mental health is not separate from physical health. Connect with Andy Dunn at andydunn.com and on Instagram

Resources: Rock Health PillPack Outlive (Peter Attia) Sunrun The Emergency (Thomas Fisher) Burn Rate (Andy Dunn) Bonobos NIH

Show Notes:

00:00 – The most advanced system in the world, and one of the most broken
00:25 – Welcome to Breaking Precedent
00:35 – Halle Tecco: growing up on Medicaid, the haves and have-nots
01:10 – Where you live predicts how long you live
02:13 – It's not effort: the incentives don't match
02:28 – "Death by pilot": an implementation problem, not innovation
03:40 – The system is rigged: incumbents, PillPack, and the DC lobby
04:33 – From the iron triangle to four aims: follow the evidence
05:23 – Founders carry the full stack
06:00 – Venture timelines vs. healthcare, and the uBiome cautionary tale
08:01 – Nobody knows what anything costs
08:25 – Built for emergencies: why inefficiency is a feature
08:56 – Dr. Thomas Fisher: "working as designed"
10:13 – The story that keeps him up at night
12:33 – Health is economic
13:03 – Misinformation, vaccines, and losing sight of the stakes
14:48 – Juking the stats, and using metrics to close the gap
17:02 – Lynn Jurich: from sick care to health span
17:43 – Neck surgery at 41 and the women's-health research gap
19:45 – Precision, prevention-first care for women
21:22 – Kevin Caldwell: prevention at the cellular l...